Functional Medicine: New Name, Old Ideas

By Jesse W. Luke

An extensive review of integrative medicine by the Australian Ministry of Health found that many of its practices aren’t supported by evidence. Now it’s going by a new name.

Integrative medicine is the practice of combining so-called “alternative” and/or “complementary” health practices with mainstream medicine. Now “functional medicine”, a pervasive subset of integrative medicine, has begun spreading from the USA to Australia. Like its parent, functional medicine claims to be a holistic, “patient-centred” approach that, according to its proponents, orthodox medicine does not offer.

In addition to the gambit of interventions common in integrative medicine, functional medicine uses supplements to a far greater extent, as in mega-vitamin dosing (known as orthomolecular medicine). It offers unsupported diagnoses such as chronic Lyme disease, often alludes to discredited medical theories such as vitalism and various vaccine dangers through ambiguous and polished rhetoric, and lists toxic emotions as a root cause of disease – a dangerous assumption that has led to patient-blaming in past ideologies and practices.

The field came into being with the creation of the Institute for Functional Medicine (IFM) in 1991 by Dr Jeffrey Bland, a chemist turned popular nutritionist. Bland is no stranger to controversy. During the 1990s and early 2000s he was in control of the food and supplement companies Healthcomm Inc. and Nu-Day Enterprises. He was listed twice as a defendant in a legal suit by the Federal Trade Commission (FTC), one of the two US government agencies responsible for the oversight of medical products, the other being the Food and Drug Administration (FDA). The FTC investigates and prosecutes claims of deceptive marketing.

The first legal challenge came in 1991 and centred on Bland’s Nu-Day Diet, which claimed without scientific evidence that its products could alter the consumers’ metabolism to aid in weight loss. The legal suit ended with a USD$30,000 fine and a consent order that no more claims of such nature be made about the company’s products without suitable evidence.

The second legal challenge was brought in 1995, and was a result of the company violating the original consent order regarding marketing of diet products by “failing to possess and rely upon substantiation for their products’ weight loss claims, reducing disease symptoms, elimination of toxins from the body, and the reduction of cholesterol and blood pressure”. This challenge resulted in another consent order and a further USD$45,000 in civil penalties.

Metagenics, a supplement company that merged with Bland’s former company HealthComm Inc. in 2000, is listed as a current sponsor of the Australasian Integrative Medical Society.

Being spared legal challenge at the time, both the IFM and the greater functional medicine movement were permitted to grow to their current state. In order to become certified as a “functional medicine practitioner” one must complete certification offered solely by the IFM. The institute lists various domestic and international health care professionals as possibly eligible, including physicians, nurses, osteopaths, chiropractors, acupuncturists and naturopaths. The process includes a fee-based application, e-learning and testing at a centre, which is often at an off-site commercial testing centre. Certification offers no legal benefit or any form of board certification. It merely creates a soft separation between the IFM and the movement as a whole.

Functional medicine has embedded itself so deeply in the American CAM community that it has acquired its own “institute” at the Cleveland Clinic. The centre is run by Mark Hyman MD, whose pop-diet books are advertised on its website, which also sports a dietary supplement store for patients. In addition, Hyman is also listed as the current chairman of the IFM and has his own centre in the US state of Massachusetts, the UltraWellness Center. The cost of a new consultation at his centre is USD$2000, and USD$2500 for a consult with Hyman himself. In exchange, they claim to aid with “detoxification and healing”, “healthy ageing’ and “many more”.

Australia has not been spared. There are at least four practitioners in the Melbourne area, according to the IFM website alone, and many more advertising throughout Australia and New Zealand, both IFM-affiliated and otherwise. The spread of this potentially harmful practice is likely to grow to levels beyond simple control, if it has not already done so.

Jesse W. Luke is an author residing in the United States. His work in non-fiction and journalism focuses mainly on the field of medicine, exploring new developments and controversies through the lens of evidence-based medicine.